A randomized, controlled trial comparing a tissue adhesive with suturing in the repair of pediatric facial lacerations

Abstract

Study objective: To compare the tissue adhesive Histoacryl Blue with suturing in the repair of pediatric facial lacerations.

Design: Prospective, randomized controlled trial.

Setting: Emergency department of a pediatric teaching hospital.

Participants: Eighty-one children presenting with clean facial lacerations less than 4 cm in length and 0.5 cm in width.

Interventions: Patients were allocated randomly to have their lacerations repaired with sutures or Histoacryl Blue.

Results: The two groups were similar for demographic and clinical characteristics. Photographs taken at three months were rated by two plastic surgeons blinded to the method of closure. There was no difference between groups for appearance scores on a visual analog scale (60.5 mm for Histoacryl Blue versus 57.2 mm for suture, P = .45) or on a categorical scale (Histoacryl Blue versus sutures: unacceptable, 11% versus 13%; acceptable, 59% versus 71%; excellent, 30% versus 16%; P = .76). Measures of observer agreement produced Pearson correlations of .72 and .94 on the visual analog scale and kappa coefficients of .46 and .73 on the categorical scale. Histoacryl Blue was assessed as less painful on a visual analog scale (24.7 versus 43.7 mm, P < .01) and faster (7.9 versus 15.6 minutes, P < .001).

Conclusion: Histoacryl Blue is a faster and less painful method of facial laceration repair that has cosmetic results similar to the use of sutures.